Basic Information
| Provider Information | |||||||||
| NPI: | 1760681928 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FUTRELL | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | EVELYN | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 654 BEACON ST | ||||||||
| Address2: | STE 2 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022152099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6786407465 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2770 LENOX RD NE | ||||||||
| Address2: | 102 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303246006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043649551 | ||||||||
| FaxNumber: | 4042610617 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2007 | ||||||||
| LastUpdateDate: | 07/26/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT009088 | GA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.